Choose Life, Not Tobacco |
Smoking is a habit that drains your money and kills your slowly, one puff after another…. |
Smoking helps you to relax… in Death-bed |
Smoking is injurious not only to you, but for the ones around you also… Quit before it’s late |
Smoking Leaves an Unseen Scar, it fill your Insides with Toxins and Tar |
Only a fool would put his lips, at the other end of a burning fie. |
Irony is, Tobacco companies kill their Best Customers. |
You’re a Fool, if you think smoking is cool. |
Tar the Roads, not your lungs. |
Be brighter, put down the lighter. |
Put the smoke out, before it put you Out. |
Who’s going to retire on your hard-earned dollars… You or some tobacco company executive? |
A Friend in Deed won’t make you smoke that weed. |
Smokers die young, be smart, don’t start. |
Every time you light up A cigarette, you are saying that your life isn’t worth Living…. |
Don’t let being on a ventilator ultimate become, the reason you eventually quit smoking. Save lungs while you can. |
If you can’t stop smoking…. Cancer will. |
Cigarettes are like Squirrels. They are perfectly harmless until you put one in your mouth and light it on fire.

Category Archives: Scientific Information

VoTV team along with the City Police Department addressed the media representatives in National Capital Region on various tobacco control laws and steps taken in its effective implementation. VoTV patron Dr. Vedant Kabra – VoTV patron, Mr. Sanjay Seth – VoTV COO, Ashima Sarin – VoTV Project Director and Assistant Commissioner of Police Mr. Rajesh Kumar address the media.
Dr. Vedant Kabra explained the scenario of tobacco devastation in the country and the state. He explained that lives of thousands of innocent people can be saved by implementing of simple steps in tobacco control laws. He conducted VoTV with a patient and her son, who was also a tobacco chewer but had quit after his mother was diagnosed witch cancer.
Mr. Sanjay Seth explained COTPA 2003 and other tobacco control laws in brief.

VoTV in collaboration with the Department of Consumer Affairs, Government of India and Cancer Research Institute Swami Rama Himalayan University had organized a media workshop to sensitize Print and Electronic media representatives about the issues of tobacco control, ban on chewing tobacco and e-cigarettes.
The event started with a welcome address by VoTV Director Ashima Sarin. VoTV, its strength nationally and extend of VoTV in helping in tobacco control worldwide was explained in brief to the gathering.

Dr. Sunil Saini shared the harms of tobacco consumption and the state figures such as number of deaths due to tobacco and cancer cases in Uttarakhand. He also applauded the move of Uttarakhand Government in banning Gutka and pan masala (containing nicotine and tobacco). He conducted VoTV with 2 patients which helped media to realize the devastation caused due to tobacco consumption.

Mumbai, 8th September 2012: It is wrongly believed that pan masala is a sort of innocent bystander that has become a casualty in the nation’s war against cancer-causing tobacco. Although the Food & Drugs Administration (FDA) of 11 states have banned gutka and pan masala together in a well-reasoned way, the common man thinks that pan masala is a simple mouth-freshener that even children may safely consume. To leave a back door open for the banned gutka industry to make a re-entry in the guise of pan masala, it is being argued in many high courts that pan masalas must not be banned. On 12th September, the Bombay High Court will be hearing the petition filed by the gutka/pan masala industry, seeking to get pan masala excluded from the scope of this ban. This was reported in The Times of India today. One sincerely hopes that the public interest will prevail over commercial interest.

Pan masala is not just an innocent mixture of arecanut cuttings, food flavours and sweeteners. It is a specialized product engineered for causing addiction, and as such, it is an ingenious mix of traditional items and innovative chemicals. New formulations are constantly being developed and introduced on the market to encourage initiation and sustained use of these products, and allied products that deliver higher “highs” to addicts. Inexpensive portion sizes and packaging render these products convenient for people to buy, carry and use, and new flavourings are tried out to appeal to young and old alike. Although these products are promoted as “safe” alternatives to tobacco smoking or chewing, no pan masala is actually safe. In fact, some varieties are more addictive and more harmful than cigarettes.

The similarity in packaging and marketing of gutkha and pan masala is no accident. They all work together as a team. Pan masala initiates unwary people and gets them to set foot on the slippery slope of addiction. Gutka, khaini etc. lie in wait further down that slope.

RMD (Rasiklal Manikchand Dhariwal) Pan Masala causes cancer. It is not just a “harmless” flavoured supari. It contains several deadly carcinogens, including some that are artificially added to the ones already present in the Areca nut or Betel nut (Supari) which is the main ingredient.

How does the mystique of pan masala work? Pan masala is based on supari, i.e. arecanut or betelnut, which is a traditional item, and a part of hindu religious ceremonies. In some communities, when the bride’s father accepts the proposal made on the groom’s behalf, he invites the groom’s side to come and have paan-supari. This engagement ceremony is called the supari-taking ceremony. Although the cancer-causing effects of supari are well publicized, it is considered safe, maybe because it is considered auspicious!

And that is one reason why traditional people like Mrs Purnima Dave, aged 36, from Banswara, Rajasthan, are coming into doctors’ clinics with cancer of the mouth, head, neck and voicebox. Respectable housewives in villages and cities are less likely to indulge in vices like chewing tobacco or gutka, but they don’t think twice before eating supari or pan masala.

Supari is nearly as dangerous for pregant mothers as alcohol drinking and tobacco chewing. If taken during pregnancy, even the unborn babies are harmed by the chemicals present in supari and pan masala. Neonatal withdrawal syndrome is reported in the newborns, and arecoline — a toxic extract of areca nut or supari – is detected in the placenta and the stools of the fetus (called meconium). Arecoline stimulates the mother’s central nervous system, reducing blood flow to the fetus. The chemicals and heavy metals present in the areca nut causes abortion, premature delivery, lower birth weight and reduced birth length.

When taken by women who are trying to concieve, supari and pan masala reduces fertility and likelihood of conception. In men, pan masala ingredients damage the testes and the sperms. A study conducted by A Kumari, B N Mojidra and others at the National Institute of Occupational Health, Ahmedabad, assessed the damage caused by pan masala to the male reproductive system in mice. Swiss albino male mice were randomly divided into 7 groups receiving either standard control diet or pan masala-containing diet. Three doses (0.5%, 1.5% and 3%) of pan masala plain (PMP) as well as pan masala with tobacco (PMT) gutkha were given for a period of 6 months. Sperm count and production were significantly decreased in both PMP- and PMT-treated groups. Both gutkha as well as panmasala plain were found to cause testicular damage, plus increase in sperms with abnormal shapes.

BEWARE! PAN MASALA MAY HAVE MORE NICOTINE THAN GUTKA

The ban order by Maharashtra Food and Drugs Administration dated 19 July 2012 highlights the risk posed by Magnesium Carbonate present in pan masala, which leads to hyper magnesia, and sometimes cardiac arrest.

Even pan masala brands marketed as “tobacco-free” contain high levels of nicotine, as revealed by a study commissioned by the Ministry of Health. While gutkha, zarda and khaini are known to contain some tobacco and are sold as such (their manufacturers don’t claim zero-tobacco content), pan masala makers promote and advertise their products as “100 per cent tobacco-less”, as they are subject to review under the 1955 rules of the Prevention of Food Adulteration (PFA) Act.

But look at the reality: laboratory analysis of randomly picked pan masala brand samples by the Central Tobacco Research Institute (CTRI), Rajahmundry, Andhra Pradesh has revealed that Rajnigandha pan masala contains 2.26 gm of nicotine per 100 gm of pan masala. This was actually more than Goa 1000 Gutkha brand, which was found to have 2.04 gm of nicotine per 100 gm of the product. Manikchand’s Gutkha RMD contained 1.88 gm nicotine. Chaini Khaini contained 0.58 gm of nicotine while Raja Khaini had 1.02 gm of nicotine per 100 gm of the smokeless product.

A parallel study by the Food Research and Standardisation Lab, Ghaziabad under the Food Safety and Standards Authority of India (FSSAI) showed that Rajnigandha pan masala contained exceptionally high nicotine levels.

In all the tested samples, pH levels were found to be carefully fine-tuned to facilitate rapid absorption of nicotine into the blood, delivering to the consumer the desired kick. The intention is clearly to make pan masalas highly addictive to one-time users and repeat-users alike.

In the words of Prakash C Gupta, Director, Healis – Sekhsaria Institute for Public Health, Navi Mumbai, “The chewing of betel quid without tobacco was not perceived as a public health problem until recently. The situation changed drastically with the advent of Pan Masala and Gutkha. These products were specifically targeted and marketed to the young. As a result, prevalence of use has increased among young individuals as has the prevalence of oral squamous fibrosis.” Combined with Indian social habits (such as traditionally offering supari or pan masala as ‘mukhwas’ or mouth-fresheners after meals), these products are deadly. Pan masala and gutka have a very high cancer burden, equalling or exceeding the cancer burden of smoking.

Gutka packets on average contain seven per cent magnesium carbonate, which is a chemical used in fire extinguishers, according to The Food And Drug Administration. The news is alarming as 206 million Indians use some form of smokeless tobacco.

World Health Organisation estimates that 26 per cent of adults in India, use some form of smokeless tobacco and 40 per cent of them die because of this addiction.

I am writing on behalf of thousands of cancer patients in India who got their cancers due to tobacco. They have started a campaign in India called – “Voice of Tobacco Victims” to use their own sad stories to deter others from picking up this habit. You may know more about this campaign from its website – http://www.vovindia.org/

Obama

Congratulation on your successful quitting! We are aware that after decades of struggle and motivation from Michelle, you have successfully quit tobacco. This will make you a proud father, a proud husband and ensure a productive life that will benefit your countrymen too. You would agree that elimination of terrorism is lot easier, though it kills a fraction of what tobacco does, than controlling tobacco companies.

The Cancer Institute (Women India Association) Chennai has urged Prime Minister Manmohan Singh to ban all tobacco-related products from being manufactured or sold in the country.
E Vidhubala, assistant professor and principal investigator, department of psycho-oncology and Tobacco Cessation Centre, Cancer Institute (WIA), Adyar told City Express that the regional directors of the cancer centres had written letters to Prime Minister Manmohan Singh to ban the tobacco products, besides raising serious concern over growing Gutka/Pan Masala menace in India. “In the letter, TG Sagar, director, Cancer Institute (WIA), hoped that the government would ban Gutkha and other tobacco products completely instead of being a silent spectator,” she said.
Interestingly, the country had the highest number of oral cancer cases in the world with 75,000 to 80,000 new cases of oral cancer being reported every year. Chewing tobacco and gutkha contributed to 90 per cent of oral cancer cases in the country, which has the dubious distinction of having the largest number of oral cancer cases in the world sparking off an alarm among the 17 regional cancer centres.
“Easy availability of this mixture of toxic substance, which contains areca nut (supari), slaked lime and certain food additives, in small, affordable pouches in every corner of the country has become a serious health hazard,” said Vidhubala.
According to the Global Adult Tobacco Survey (GATS 2010) released in October 2010, nearly one-third of Indian population, including children and youth, were addicted to smokeless tobacco. Depending upon the geographical areas, different names with different combinations of smokeless tobacco were marketed, such as Mawa, Khaini, Gudakhu, panni etc.
Vidhubala said there were 3,095 chemical components in tobacco and among them 28 were proven carcinogens. The major and most abundant group of carcinogens was the Tobacco-specific N-nitrosamines (TSNA) and N-nitrosoamino acids. The nitrosamine level was directly related to the risk of cancer.
Scientific evidence had established that tobacco chewing caused cancer of the mouth, oesophagus (food pipe), larynx and pharynx (throat), pancreas, stomach, kidney and lung. It can also caused high BP and other life threatening cardiovascular conditions like myocardial ischemia and stroke. The use of smokeless tobacco during pregnancy could cause still-birth, low birth weight, premature delivery, anaemia (to the mother) and several complications during delivery, says Vidhubala

17 regional cancer centers in India have urged the Prime Minister, Dr. Manmohan Singh, to impose a countrywide ban on the sale of tobacco products like gutka and pan masala. Following which the Supreme Court of India is soon considering to impose a total ban on gutka and other forms of smokeless tobacco products. In India tobacco chewing is the leading cause of oral cancer. With more than 1million Indians dying of cancer per year, India is known as the world capital for oral cancer.
7-13% children aged 10-15 years consume smokeless tobacco products, while 3 out of 4 adults use these products with 1 of them being addict to the products. These gutka, mawa and khaini products contain about 3095 chemical products out of which 28 have been proved as carcinogens that can lead to cancer of the esophagus, throat, pancreas, stomach, kidney and lungs. It has been found that gutka products contain heavy metals like lead, arsenic, cadmium and copper.
Social activists are looking forward for the implementation of this ban as they are fed up with the cases suffering from smokeless tobacco usehttp://www.medindia.net/news/Government-to-Impose-Countywide-Ban-on-Smokeless-Tobacco-Products-83605-1.htm

3) The Indian Express, April 13 – AhmadabadGutkha behind most oral cancer cases in Gujarat: GCRI
With the Supreme Court likely to hear a petition on the ban of plastic pouches for gutkha on Wednesday, the regional cancer centre in Gujarat has sought to draw attention to the harmful effects of tobacco.
This assumes significance as, according to the Gujarat Cancer and Research Institute (GCRI), the number of oral cancer patients remains the highest among other cancer cases reported at the institute every year.
GCRI director Dr Shilin Shukla said that of the 18,000-odd cancer patients detected by the institute annually, nearly 40 per cent are found to have cancer due to eating gutkha and other smokeless tobacco products. “We understand Gujarat is the state with the highest, or at least one of the highest rates of such cancers in the world,” he said, explaining this might be so because of the “culturally accepted” consumption of tobacco.
Smoking, he said, had much less effect as it is not as widespread.
“Smokeless tobacco contains nicotine, which is highly addictive,” said a GCRI release, adding the having such tobacco during pregnancy can cause still birth, low birth weight, premature delivery, anaemia and several complications during delivery.
Dr Shukla’s predecessor, Dr Pankaj M Shah, had even written to the Prime Minister’s Office in January to highlight the medical situation arising out of smokeless tobacco consumption in the state. The letter was one of the 16 such letters written by the directors of all 16 regional cancer centres across the country demanding a ban on smokeless tobacco products.http://www.indianexpress.com/news/gutkha-behind-most-oral-cancer-cases-in-gujarat-gcri/775541/

4) NewKerala: April12 – OnlinePM gets letters to weed out oral cancer

In a joint move to check the use of ubiquitous pan masala and the resultant oral-cancer, the director of Chittaranjan National Cancer Institute (CNCI), Kolkata, and 16 other directors of regional cancer centres in India have written to Prime Minister Manmohan Singh to ban smokeless tobacco products.

On an average, annually more than 1,000 new patients suffering from oro-pharyngeal cancer (a form of oral- cancer), many of which are related to gutka use, are registered at CNCI.

It is observed that magnitude of tobacco related cancer in average is on an upward trend in eastern and north eastern India.

This is largely due to high prevalence of tobacco consumption. India has the highest number of oral cancer in the world with 75,000 to 80,000 new cases of oral cancers being reported every year and chewing tobacco and gutka contribute to 90 percent of oral cancer cases in the country.

According to the Global Adult Tobacco Survey (GATS 2010) released in Oct., 2010 nearly one third of Indian population is addicted to smokeless tobacco.

A large number of children and youth in India are addicted to smokeless tobacco. These preparations essentially have tobacco with or without supari and are well proven to be harmful for health.

5) The Hindu Business Line: April 12 – OnlinePM urged to ban sale of tobacco products

By: Carried by PTI

Seventeen regional cancer centres in India have urged the Prime Minister, Dr Manmohan Singh, to ban the sale of tobacco products like gutka and pan masala in the country.

“India has the highest number of oral cancer cases in the world with 75,000 to 80,000 new cases being reported every year and chewing of tobacco and gutka contribute to 90 per cent of oral cancer in the country,” Mr. Jaydip Biswas, Director, Chittaranjan National Cancer Institute (CNCI), said here.

He said the 17 regional cancer centres, including CNCI, had decided to join hands to fight the menace and urged the Prime Minister in this regard.

In a communication to the Prime Minister, the regional cancer centre directors said that easy availability of the mixture of toxic substances, which contain areca nut (supari), slaked lime and certain food additives, in small affordable pouches in every nook and corner of the country, has become a serious health hazard.

According to the Global Adult Tobacco Survey (GATS) 2010, nearly one-third of Indian population is addicted to smokeless tobacco.

“A large number of children and youth in India are addicted to smokeless tobacco, which contains nicotine, which is highly addictive. There are 3,095 chemical components in tobacco, among them 28 are proven carcinogen,” Mr Biswas said.

The major and most abundant group of carcinogens is the tobacco-specific N-nitrosamines and N-nitrosoamino acid.

According to the GATS, 34.6 per cent adults consume some form of tobacco in India, 25.9 per cent adults use smokeless tobacco and 14.1 per cent of youth in India between 13-15 years of age currently use any form of tobacco products.

The survey said that about two in three adults notice advertisements on promotions of tobacco products. Three in five current tobacco users (61.1 per cent) notice the health warning on tobacco product packages and one in three current tobacco users (31.5 per cent) thought of quitting because of the warning label.

The CNCI director said the magnitude of tobacco-related cancer, on an average, was on an upward trend in eastern and north-eastern India.

“This is largely due to high prevalence of tobacco consumption,” he said, adding that there was not much control on production and sale of gutka which is sold everywhere.

The director said that to combat such a dreadful situation, a strong campaign was required to be launched to regulate production, sale and use of gutka and pan masala in greater public interest

Directors of 17 regional cancer centres in the country have written to Prime Minister Manmohan Singh, urging him to bring in a ban on smokeless tobacco products, including gutka and pan masala. India has the highest number of oral cancer patients in the world.
According to a press release issued by the Chittaranjan National Cancer Institute (CNCI) here, one of those to have written to Dr. Singh, between 75,000 to 80,000 new cases of oral cancer are reported every year, a figure to which tobacco-chewing contributes 90 per cent.

“The easy availability of this mixture of toxic substances, including the areca nut (supari), slaked lime and certain food additives, in small affordable pouches in every nook and corner of the country has become a serious health hazard,” the release said. Different combinations of the product — mawa, khaini, gudakhu and panni — were available in different regions.

YOUTH TARGETED

CNCI director Jaydip Biswas said the tobacco industry had been targeting the youth by selling tobacco products outside schools and colleges, distributing free samples and getting endorsements from film stars.

He said more than 1,000 new cases of patients suffering oropharyngeal cancer — many caused by chewing gutka — were reported at the institute annually, and the number of users showed an upward trend.
http://www.thehindu.com/health/policy-and-issues/article1691864.ece

The Regional Cancer Centre (RCC) director Dr Paul Sebastian, along with his counterparts in 17 other Regional Cancer Centres, has called for a total ban on smokeless tobacco products such as gutka and pan masala, which contribute in a huge way to causing oral cancer. While the country has the highest number of oral cancer patients in the world with nearly a lakh new cases being reported every year, studies have found that chewing tobacco and gutka caused almost 90 percent of the oral cancer.

Scientific evidence has also established that tobacco chewing causes cancer of mouth, oesophagus, larynx and pharynx, pancreas, stomach, kidney and lung.

”It is in this background that we, the directors of all 17 regional cancer centres, decided to join hands to fight the gutka menace. We have written letters to the Prime Minister, Opposition Leader, Minister of State for Health and Family Welfare and over 40 Parliament members, appealing for a ban on the sale of pan masala like products in the country,” said RCC director Dr Paul Sebastian.

Smokeless tobacco such as gutka and pan masala products with commercial names such as shambu, chaini khaini, ganesh, cool lip and so on have in its fold nearly a third of the Indian population addicted to it, including schoolchildren, says a report of the Global Adult Tobacco Survey (GATS 2010). The small and inexpensive pouches of pan masala are sold without restriction at every nook and corner of the country and are easily available to the youth and even small children. In fact, the health specialists have long argued that the tobacco industry had been targeting youth and children by selling tobacco products outside schools and colleges, distributing free samples and even getting film stars to endorse these products. All these preparations of smokeless tobacco have been proven to be harmful to life. The use of smokeless tobacco during pregnancy can cause still birth, low birth weight, premature delivery, anaemia of mother and several complications during delivery. Smokeless tobacco also contains nicotine, which is highly addictive. Apart from the tobacco component, these pouches have a mixture that is concoction of toxic substances containing even slaked lime and food additives.

Scientists have identified as many as 28 components in tobacco, which have been proved to cause cancer, majority of them belonging to the group of tobacco specific Nnitrosamines and Nitrosoamino acids.

The GATS survey had found that more than a quarter of adults in India use smokeless tobacco and what is worse is that over sixty percent among the daily tobacco users consume tobacco within an hour of waking up. ”We have raised serious concern over the growing gutka, pan masala menace in the country and have urged the Government of India to show some urgency in addressing the issue,” said Dr Paul Sebastian.

The directors of 17 regional cancer centers in the country and the Director of Tata Memorial Centre, a cancer hospital in Mumbai, have joined hands to appeal for a ban on the sale of smokeless and chewable tobacco products, such as ‘Gutkha’ and ‘pan masala,’ in the country.

Given the huge burden of oral and head-and-neck cancers in the State and elsewhere in the country, the government needs to show some urgency in addressing this issue, Paul Sebastian, Director of the Thiruvananthapuram centre, said in a statement here.

India has the highest number of oral-cancer patients in the world, with 75,000 to 80,000 new cases being reported annually. Chewing tobacco products, such as ‘gutkha,’ contribute to nearly 90 per cent of these cancers. The easy availability of these mixtures, which contains areca nut or supari , slaked lime and certain food additives and flavourings, in small pouches and at affordable rates in every nook and corner of the country is posing a grave health hazard to the younger generation, the experts have pointed out.

The Global Adults Tobacco Survey released in October 2010 says nearly one-third of the Indian population, especially children and youth, is addicted to smokeless tobacco. The combinations of smokeless tobacco are sold in different names, such as ‘Mawa,’ ‘Khaini,’ ‘Gudakhu,’ and ‘Panni,’ but all of these contain tobacco with or without supari and are harmful to health. Some of these products are often marketed in the guise of mouth fresheners.

SC concerned over rising death due to tobacco-induced cancer
PTI | 09:04 PM,Apr 13,2011
New Delhi, Apr 13 (PTI) The Supreme Court today expressed concern over growing number of deaths, especially in rural areas, due to cancer caused by chewing tobacco. A bench of justices G S Singhvi and K S Radhakrishnan expressed the concern while hearing the issue of sale of gutka and other tobacco products like and pan masala in plastic sachets which the government has banned since March 1 this year on the court”s directive. While expressing concern over rising cancer deaths in rural areas, the court said it will begin hearing the issue on a regular basis from July 20 when it would hear all stakeholders in the sector, including the tobacco manufacturers and civil societies. “We have read newspaper reports of Chittaranjan National Cancer Institute (CNCI) which said that 75,000 to 80,000 cases of oral cancer are reported every year and most of these are due to tobacco-chewing,” the bench said. CNCI has written a letter to the Prime Minister requesting a ban on tobacco products like gutka and pan masala in the country. The institute has said easy availability of the mixture of toxic substances, which contain areca nut (supari), slaked lime and certain food additives, in small affordable pouches in every nook and corner of the country has become a serious health hazard.

Gutka ban: Cancer centre heads write to PMMedicos call for total ban on the smokeless tobacco products rather than just their packaging material
SONAL MATHARU | NEW DELHI | APRIL 12 2011
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To put pressure on the government prior to the supreme court hearing on the ban on plastic sachets of smokeless tobacco packets on Wednesday, directors of 16 regional cancer centres in India wrote letters individually to prime minister Manmohan Singh urging him to ban the sale and manufacturing of these products and not just the packing material.

A copy of the letters was also mailed to health minister Ghulam Nabi Azad where the directors indicate a change in trend observed over the decades as the number of mouth cancers caused due to consumption of gutka and pan masala have risen sharply all over the country.

“Oral cancer has now become more prominent with the extensive use of smokeless tobacco. Earlier more cases were recorded of throat and lung cancer due to smoking, now we see people between 20 to 40 years old suffering from mouth cancer,” said Dr Pankaj M Shah, honoraray director, Gujarat Cancer and Research Institute.

Dr Rajendra A Badwe, director, Tata Memorial Centre, Mumbai, Maharashtra, writes in his letter that pan masala has supari in it which is an addictive substance and has cancer causing properties. “Since pan masala and gutka are marketed as mouth fresheners, its habit starts at a very young age. If we need to reduce the oral cancer burden in india, we need to control the rampant habit of tobacco and areca nut chewing,” he wrote in his letter.

A senior official from the health ministry said that the letters ministry received were part of the response filed in the court for banning plastic sachets for smokeless tobacco products. The supreme court banned the sale of chewing tobacco in plastic sachets from March 2011. A bench of justices GS Singhvi and AK Ganguly gave the direction while hearing petitions filed by tobacco manufacturers challenging Rajasthan high court’s order on such a ban in the state. While hearing the case, the court asked the health ministry to file a report on the harmful effects of smokeless tobacco products.

“The ministry had a consultation with the stakeholders earlier this month and banning smokeless tobacco products was considered, but right now we cannot say if this step would be immediately taken,” the official added.

As per the health ministry, one-third Indians consume smokeless tobacco. Chewing gutka also leads to a precancerous condition called oral sub mucous fibrosis where the muscles in the mouth lose their ability to stretch.

“Not only men, but school children and housewives are also addicted to chewing tobacco products. Many people keep gutka it their mouth even while sleeping, so this is worse than smoking a cigarette,” said Dr R K Chaudhary, director, Acharya Tulsi Regional Cancer Treatment and Research Institute, Bikaner, Rajasthan.

“Our government is spending huge amount of money on cancer control programme and on the other hand we are not removing the root causes of cancers, that is, tobacco and gutka which are known causes of cancer development,” Chaudhary wrote in his letter.

Tobacco is the single most important risk factor for cancer, cardiovascular and chronic respiratory diseases. Tobacco prevalence is very high in the north eastern region as a result, 55 to 60 percent of all cancers in the region are tobacco related.

As per global school personnel survey 2006, 34.3 percent children between 13 to 15 years consume tobaco in the north eastern region. Tobacco products are distributed free in and around educational institutions, hospitals and hospital premises, wrote Dr A C Kataki, director, Dr Bhubaneshwar Borooah Cancer Institute, Guwahati, Assam.

“In the city of Guwahati alone, gutka worth Rs 12 lakh is sold everyday. 6.5 lakh sachets of gutka and 3.2 lakh packets of cigarettes are sold everyday in Assam,” Kataki added.
Dr Gautam Majumdar, medical superintendent, Regional Cancer Centre, Agartala, Tripura wrote that with the “look East” project of the government, cheap gutka packets are now easily available in the state and tobacco consumption has doubled recently.

Agreeing that the next best option to a ban is raising taxes on the products, the ministry official said, “If not a ban, then taxing tobacco products is seen as a best practice. Reports have shown that an increase in taxes reduces consumption but right now, only cigarettes come under the tax bracket and not locally produced smokeless forms of tobacco. These are still sold too cheap. Like few states, the centre could also take the step of imposing higher taxes on chewing tobacco.”

Refusing to lift the ban on sale of tobacco products like gutka and pan masala in plastic sachets, a bench of justices G S Singhvi and K S Radhakrishnan allowed all impleadment applications of various stakeholders, saying the court will hear all their concerns.

The Supreme Court today allowed several civil societies and manufacturers of non-smoking, chewing tobacco products including gutka to become a party to the hearing of a plea against their sale in plastic sachets.

Refusing to lift the ban on sale of tobacco products like gutka and pan masala in plastic sachets, a bench of justices G S Singhvi and K S Radhakrishnan allowed all impleadment applications of various stakeholders, saying the court will hear all their concerns.

The bench also directed solicitor general Gopal Subramaniam to file the government’s reply to issues raised by the stakeholders within four weeks.

Gutka manufacturers and NGO’s will have to subsequently file their replies to the government’s submission in another four weeks.

The bench also directed the government to make available to concerned parties within two weeks the copies of the report dated February 17, 2011 on use of tobacco.

The court will start its hearing from July 20 and said there would be no adjournments in the case.

Earlier the government had notified the law banning plastic packaging of non-smoking tobacco products on February 4 after the bench had rebuked it on February 2 for not implementing the law and asked it to notify the same within two days.

Endorsing the Rajasthan High Court order, the bench had on December 7 last restrained gutka, pan masala and chewing tobacco manufacturers from using plastic as packaging material for their products from March 1 this year.

It had also ordered the government to entrust an independent agency with the task of testing the contents of these sachets to evaluate the risk they pose to consumers.

CHENNAI: The Cancer Institute (Women India Association) Chennai has urged Prime Minister Manmohan Singh to ban all tobacco-related products from being manufactured or sold in the country.
E Vidhubala, assistant professor and principal investigator, department of psycho-oncology and Tobacco Cessation Centre, Cancer Institute (WIA), Adyar told City Express that the regional directors of the cancer centres had written letters to Prime Minister Manmohan Singh to ban the tobacco products, besides raising serious concern over growing Gutka/Pan Masala menace in India. “In the letter, TG Sagar, director, Cancer Institute (WIA), hoped that the government would ban Gutkha and other tobacco products completely instead of being a silent spectator,” she said.
Interestingly, the country had the highest number of oral cancer cases in the world with 75,000 to 80,000 new cases of oral cancer being reported every year. Chewing tobacco and gutkha contributed to 90 per cent of oral cancer cases in the country, which has the dubious distinction of having the largest number of oral cancer cases in the world sparking off an alarm among the 17 regional cancer centres.
“Easy availability of this mixture of toxic substance, which contains areca nut (supari), slaked lime and certain food additives, in small, affordable pouches in every corner of the country has become a serious health hazard,” said Vidhubala.
According to the Global Adult Tobacco Survey (GATS 2010) released in October 2010, nearly one-third of Indian population, including children and youth, were addicted to smokeless tobacco. Depending upon the geographical areas, different names with different combinations of smokeless tobacco were marketed, such as Mawa, Khaini, Gudakhu, panni etc.
Vidhubala said there were 3,095 chemical components in tobacco and among them 28 were proven carcinogens. The major and most abundant group of carcinogens was the Tobacco-specific N-nitrosamines (TSNA) and N-nitrosoamino acids. The nitrosamine level was directly related to the risk of cancer.
Scientific evidence had established that tobacco chewing caused cancer of the mouth, oesophagus (food pipe), larynx and pharynx (throat), pancreas, stomach, kidney and lung. It can also caused high BP and other life threatening cardiovascular conditions like myocardial ischemia and stroke. The use of smokeless tobacco during pregnancy could cause still-birth, low birth weight, premature delivery, anaemia (to the mother) and several complications during delivery, says Vidhubala.

The Directors of 17 Regional Cancer Centres in India, including the Tata Memorial Centre (TMC), have written letters to the Honorable Prime Minister Shri Manmohan Singh to ban smokeless tobacco products. In letters to him and the health ministry, all of them have raised serious concern over growing Gutka/Pan Masala menace in India and have urged the Government of India to show some urgency in addressing disaster.

India has the highest number of oral cancer in the world with 75, 000 to 80, 000 new cases of oral cancers being reported every year. And chewing tobacco and gutka contribute to 90 per cent of oral cancer cases in the country. Easy availability of this mixture of toxic substance which contains areca nut (supari), slaked lime and certain food additives, in small, affordable pouches in every nook and corner of the country has become a serious health hazard.

According to the Global Adult Tobacco Survey (GATS 2010) released in Oct 2010, nearly one third of Indian population is addicted to smokeless tobacco. A large number of children and youth in India are addicted to smokeless tobacco. Depending upon the geographical areas, different names with different combinations of smokeless tobacco are marketed, such as Mawa, Khaini, Gudakhu, panni etc. All these preparations essentially have tobacco with our without supari and are well proven to be harmful for health.

Smokeless tobacco contains nicotine, which is highly addictive. There are 3095 chemical components in tobacco, among them 28 are proven carcinogen. The major and most abundant group of carcinogens is the tobacco-specific N-nitrosamines (TSNA) and N-nitrosoamino acids. The nitrosamine level is directly related to the risk of cancer. Scientific evidence has established that tobacco chewing causes cancer of mouth, oesophagus (food pipe), larynx and pharynx (throat), pancreas, stomach, kidney and lung. It can also cause high blood pressure and other life threatening cardiovascular conditions like myocardial ischemia, stroke etc.The use of smokeless tobacco during pregnancy can cause still birth, low birth weight, premature delivery, anaemia of mother and several complications during delivery.

The tobacco industry has been targeting youth and children by selling tobacco products outside schools and colleges, distributing free samples and getting film stars to endorse these killer products through attractive advertisements on TV, radio, newspapers, billboards and buses.

Action Council Against Tobacco (ACT India), Healis-Sekhsaria Institute for Public Health, Salaam Bombay Foundation and Voluntary Health Association of India (VHAI) also facilitated an event in Delhi conceptualized by cancer victims who gathered together to promote greater awareness about the harmful effects of tobacco use. These victims and their families shared their stories and experiences as well as voiced their appeal for stronger enforcement of tobacco control laws and presented a charter of demands to Ms Sushma Swaraj, leader of Opposition in Lok Sabha, Union Coal Minister Sriprakash Jaiswal and Minister of State for Health & Family Welfare, Shri Dinesh Trivedi and over 40 MPs. Ms Swaraj, in the recently concluded parliamentary session, raised the need for implementing effective tobacco control measures in the country to save 1 millions that are lost annually in India due to tobacco related diseases

Global Adult Tobacco Survey, (GATS-India) Highlights:
• 34.6% adults (47.9% males and 20.3% females) currently some form of tobacco in India.
• 25.9% adults (32.9% males and 18.4 % females) in India use smokeless tobacco.
• Among daily tobacco users, 60.2% consume tobacco within half an hour of waking up.
• 14.1% of youth in India between the ages 13-15 years currently use any tobacco products.
• 11.9% of youth in India between the ages 13-15 currently use tobacco products other than cigarettes.

• 5500 children and adolescents start using tobacco products daily.

• About two in three adults (64.5%) noticed advertisements or promotions of tobacco products.

• Three in five current tobacco users (61.1%) noticed the health warning on tobacco product packages and one in three current tobacco users (31.5%) thought of quitting because of the warning label.

The term “Head and Neck cancer” encompasses a wide range of cancers that occur in several areas of the head and neck region, including the nasal passages, sinuses, mouth, throat, larynx, swallowing passages, salivary glands, and the thyroid gland. Skin cancers that develop on the scalp, face, or neck may also be considered Head and Neck cancers. Head and neck cancer can develop in anyone, but people who use tobacco in any form (including cigarettes, cigars, pipes, bidis, chewed as quid, with betel nut and smokeless tobacco) or drink alcohol excessively are much more likely than others to develop the disease. Most of these cancers are preventable with moderation in alcohol and by refraining from tobacco use.

Below are some of the symptoms and warning signs of head and neck cancer. Many of these symptoms can be caused by other, non-cancerous conditions as well. See your doctor if you notice any of these problems.
• A sore in the mouth that won’t heal (the most common symptom) or that bleeds easily
• A red or white patch in the mouth that doesn’t go away
• Frequent nosebleeds, ongoing nasal congestion, or chronic sinus infections that do not respond to treatment
• Persistent sore throat
• Persistent hoarseness or a change in the voice
• Pain in the neck, throat, or ears that won’t go away
• Blood in the sputum
• Difficulty chewing, swallowing, or moving jaws or tongue
• Numbness in the tongue or other areas
• Loosening of teeth
• Dentures that no longer fit
• A lump or swelling in the neck
• Changes in a mole or discoloration, or a sore on the skin that is crusting, ulcerated, or fails to heal (these are also signs of skin cancer)

TYPES OF CANCERS

There are many different types of head and neck cancer. Several of them are described below. Most head and neck cancers are squamous cell carcinomas, i.e cancers arising from the mucosal lining .

• Oral cancer is cancer that arises in the mouth, or oral cavity. The oral cavity includes the lips, the gums and the area behind the wisdom teeth, the inside of the lips and cheeks, the floor and roof (hard palate) of the mouth, and the front two-thirds of the tongue.
• Laryngeal (Voice Box) cancer begins in the larynx, an organ also known as the voice box. The larynx sits at the top of the trachea, the respiratory tube that leads to the lungs. Air passes through the larynx on the way to the lungs. The vocal cords, two bands of muscle, are found within the larynx and are used for speech. The larynx also prevents food from entering the lungs.
• Nasal cavity and paranasal sinus cancers are found in the tissues that line these hollow structures. The paranasal sinuses are hollow areas in the bones of the face near the nose that produce mucus. The nasal cavity is found just behind the nose and is used to condition the inhaled air before passing it throat.
• Nasopharyngeal cancer is found in the nasopharynx, the uppermost portion of the throat (pharynx). It begins just behind the nose and extends to the oropharynx, the portion of the throat found just behind the mouth. It also includes two openings that lead to the ears. (The entire throat is called the pharynx, and is made up of the nasopharynx, the oropharynx just below that, and the hypopharynx, the lower region that meets the esophagus.)
• Oropharyngeal cancer is found in the section of the throat (oropharynx) located just beyond the mouth. The region also includes the base of the tongue, the soft palate (the soft area just beyond the roof of the mouth), and the area around the tonsils.
• Hypopharyngeal cancer is found in the hypopharynx, the uppermost portion of the esophagus (the tube through which food travels to the stomach). The hypopharynx surrounds the larynx.
• Salivary gland cancer – It is found in the salivary glands, the structures that produce saliva to keep the mouth from drying out and aid in the digestion of food. Salivary glands may be found in front of the ears (parotid), under the jaw (submandibular), underneath the tongue (sublingual), and in other areas of the upper aerodigestive passages including the nose, sinus, mouth, and throat.
• Thyroid cancer – It develops in the thyroid gland, a small H-shaped structure that wraps around the front of windpipe in the lower part of the neck. The thyroid gland is the source of important hormones that help regulate metabolism, blood pressure, heart rate, temperature and other functions. Thyroid gland cancers are hereditary, or related to a lot of dietery and environmental factore like Iodine deficiency and radiation exposure. It also is more common in females.

RISK FACTORS

Because most head and neck cancers arise after prolonged exposures to known risk factors, these cancers are often considered preventable. Risk factors for head and neck cancers include tobacco and alcohol use, a history of pre-cancerous lesions, and exposure to cancer-causing agents in the environment. People who use tobacco in any form or drink alcohol excessively are at much greater risk for the disease. For example, smoking raises the risk of cancer of the larynx (voice box) or hypopharynx to 5 to 35 times the risk of nonsmokers. Heavy use of alcohol raises the risk of those cancers 2 to 5 times. Those who smoke and also drink heavily might be raising their risk to 100 times that of non-users.

INVESTIGATIONS AND DIAGNOSIS

Doctors perform any of several types of tests that can help to make a definitive diagnosis of a head and neck cancer and to determine the stage of the cancer, or how far it has progressed. Treatment is decided depending on the stage of the cancer at diagnosis.

Physical Examination & History
First, the doctor takes a complete medical history, noting all symptoms and risk factors. Then comes a thorough examination of the head and neck area, during which the doctor will feel for abnormalities and looking at the inside of your mouth and throat, and on the neck for lumps.

Endoscopy
The doctor may use mirrors and lights to examine hard-to-see areas and may also use a flexible, lighted tube (fibre optic or a Hopkins’scope) to examine areas that are less accessible. The tube may be inserted through the nose or mouth; an anesthetic spray may be used to make the examination more comfortable. This examination is called a nasopharyngoscopy, pharyngoscopy, or laryngoscopy, depending on which area is examined. Occasionally, this type of examination will be done while the patient is under general anesthesia so a very thorough inspection can be done; this is called a panendoscopy.

Imaging Tests
The doctor may also suggest several other tests, including imaging procedures such as a CT or computed tomographic scan (a special type of x-ray), an MRI or magnetic resonance image scan (which uses magnetic waves to produce pictures), or an ultrasound exam (which uses sounds waves to produce images). Doctors also now use PET (positron emission tomography) scans to help diagnose head and neck cancers, but this is not yet a routine practice. Currently, research is investigating whether PET scans will improve the ability to detect the spread of cancer to lymph nodes in the neck and other areas of the body.
Other possible tests include an orthopentogram (a special x-ray of the jaws), a barium swallow, dental x-rays, chest x-rays, and a radionuclide throid scan in case of thyroid cancers.Biopsy
If a suspicious area is noted, the doctor may do a biopsy: he or she will remove a small piece of tissue with either a scalpel or a needle, and send it to a laboratory for examination under a microscope. Biopsies are often done when the patient is under general anesthesia. Biopsies of easily accessible areas are done under local anesthesia. Before starting any form of treatment, a biopsy is mandatory to prove the diagnosis.

TREATMENT

Many cancers of the head and neck can be cured, especially if they are found early. Treatment varies according to the type, severity, and location of the disease. It may include surgery (the primary treatment method), radiation therapy, or chemotherapy. Increasingly, oncologists are combining treatment modalities to maximize chances of curing the cancer.
Although cure of the cancer is the primary goal in treatment, preserving a patient’s appearance and ability to function, and thus the quality of life, also are very important goals and are considered an integral part of treatment. Today, advances in surgical techniques, reconstruction, and non surgical treatment methods combined with a comprehensive team approach, which brings the expertise of numerous specialists to each patient’s care have made it possible to attain those quality of life goals in nearly every patient receiving treatment.

Surgery

Surgery is the mainstay of treatment for most cancers of the head and neck. Loss of speech was once common after head and neck surgery, because of damage to the larynx (voice box). Continual advances in surgical techniques, however, allow more patients to preserve normal functioning. Surgeons have perfected techniques, for example, that remove only part of the larynx instead of the entire organ. Indeed, larynx-preserving surgery is possible in more than half of the cases that once would have required that organ to be completely removed. Also, now we have gadgets which can be inserted into the throat which will help patient to speak even after his larynx has been removed completely. Other advances now allow doctors to spare the jaw or replace it with some other bone from the patient’s body to maintain a normal face. Also the eye can be spared when a tumor is crowding that area.
When surgery is extensive, immediate reconstruction of the area is often possible. For example, in cases where the jaw bone must be removed, a surgeon can fashion a new jaw using bone from the patient’s own leg. Blood vessels are moved along with the leg bone and are attached to blood vessels in the neck, creating a blood supply for the new jaw. Similarly, skin and muscle from a patient’s back or abdomen can now be used to replace part of the scalp. Dental implants can be used to replace teeth.

Radiation Therapy

Radiation therapy may involve external beam treatment or brachytherapy, a technique in which tiny radioactive seeds are implanted directly in a tumor. In some cases, both approaches are used. Radiation therapy is often given in conjunction with surgical treatment, but studies are showing that in some cases, radiation therapy sometimes combined with chemotherapy is just as effective as surgery. These new approaches can often preserve the ability to speak and swallow normally, even in patients with advanced disease.

Chemotherapy

The use of chemotherapy in head and neck cancer is also expanding, especially in cases that previously would have been considered untreatable. Chemotherapy is often used to enhance the response of cancer cells to radiation therapy, and often makes it possible to preserve organs, such as the larynx, that once would have been removed. For patients with advanced disease, too, chemotherapy is helping to increase longevity; this is especially true in patients who have cancer of the nasopharynx or other areas that are not easily treated surgically.

APPROACH TO HEAD AND NECK CANCER

Treatment

Early stage disease
• Surgery alone is often the standard of care for early stage disease.
• Radiation therapy alone is also acceptable for stage I and II malignancies, although squamous cells are only moderately radiosensitive.

Late stage disease
• Surgery is part of a combination approach, either before or after other modalities.
• Radical or modified neck dissection if there is cervical lymph node spread.
• Reconstructive procedures are very important adjunct to tumor resection.
• Radiation therapy plays role in large, unresectable tumors for palliation and preservation of speech and swallowing functions.
• Chemotherapy combination regimens have not yet demonstrated better tumor control or survival when used alone. However, many late stage disease patients are at risk of occult metastases and/or recurrence, thus chemotherapy plays a role.

Focus on Quality of Life
When planning a course of treatment for a patient, doctors place great emphasis on quality-of-life issues, such as the ability to speak or swallow. Surgery is the primary form of treatment for head and neck cancers, and today such surgery is often much less disfiguring than patients may fear. Numerous surgical procedures have been developed that permit removal of tumors from complex areas, such as the base of the skull, that were not possible in the past and, at the other end of the spectrum, preserve organ function and facial appearance to a far greater degree than was possible in the past, while keeping cure of the cancer as the main goal.
Indeed, the standards of care for head and neck surgery have changed substantially in recent decades. Reconstructive surgery has improved dramatically, expanding the range of tumors that can now be removed surgically and yielding previously unattainable cosmetic and functional outcomes. Research data indicates that the results of complicated surgical procedures like these are best when the procedures are done by specialists who perform them on a regular basis.

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About Us

The name “cancer” makes everyone fearful. This word is considered synonymous with death. No one would ever know the pain associated with this disease more than us who had undergone this unfortunate experience. We live under threat of re-occurrence of the disease and the fear of death always haunts us.